RESUMO
Background:The United Nations Inter-Agency and Expert Group on Millennium Development Goals (MDGs), established incidence rate as one of the indicators for monitoring progress on Malaria control. Data on malaria incidence rates in Edo State, Nigeria, 2006-2013 were published in 2015. The current study focused on incidence rates, 2014-2018. In addition, trends in malaria diagnoses were also investigated.Methods:Records of numbers of patients from the 18 Local Government Areas (LGAs) complaining of malaria, at LGA Health Centres, State Hospitals, etc. were obtained from the Department of Disease Control, State Ministry of Health, Benin City. Patients were placed in 3 categories: Fever, without malaria confirmation, confirmeduncomplicated, confirmed severe. Human population records over the 5-year period were obtained from the Nigeria Population Commission, Benin City. Incidence rates were calculated and relative proportions of patients in the 3 categories determined.Results:The numbers of fever cases, without malaria confirmation, varied across LGAs and constituted 58.00-68.00% of all fever cases annually. In confirmed cases of malaria, most were uncomplicated. The highest numbers of confirmed cases were in Egor and Oredo LGAs. The pattern was similar in uncomplicated and severe cases. The ratios of uncomplicated and severe cases of malaria varied significantly (p<0.05) annually. Malaria incidence rates varied among LGAs in each of the years: 2014 (0.75-5.48%), in 2015 (0.24-2.55%), in 2016 (1.44-5.21%), in 2017 (1.17-9.69%), in 2018 (0.63-4.03%). However, these differences were not significant (p>0.05). In the period 2014-2018, malaria incidence rates of 5.00% and above were recorded only 5times across LGAs: Egor, 2014 (5.48%); Esan Central, 2016 (5.14%; Ovia southwest, 2016 (5.21%), 2017 (9.69%); Uhunmwnde, 2017 (5.05%).Conclusion:The decline in malaria incidence rates, 2014-2018, over the 2006-2013 data indicates progress. However, there are still daunting challenges which have been detailed in the text. These results also highlight the need for malaria test confirmation rather than utilizing fever as the exclusive symptom for malaria. All stakeholders must intensify efforts to ensure that this downward trend in malaria incidence rates is sustained
RESUMO
Background: Detailed information on the severity of malaria and other diseases across operational areas is a prerequisite to the judicious utilization of limited effective tools for the control in Africa. Methods: Records of Patients, from the 18 Local Government Areas (LGAs), who visited Health Centres across Edo State, 2006-2013, and stored in the Ministry of Health database in Benin City were analysed. Patients were placed in 3 groups (out-patients, In-patients, Pregnant Women). Human population data, in the 18 LGAs over the period were obtained from the National Population Commission. Malaria incidence rates were estimated. The proportions of patients in the 3 categories annually across LGAs were determined. Results: Malaria Incidence rates increased 2-13 folds over the period in all LGAs, except in Esan West where there was a significant reduction in 2011. The highest rates were recorded at Esan Central (13.66%) and Uhunmwonde (11.50%). The highest increases in the proportions of patients with severe malaria were at Uhunmwonde, Igueben and Orhionmwon LGAs. In contrast, reductions in the proportions of severe malaria were in Esan Northeast and Owan West. The highest increases in the proportions of pregnant women patients were in Esan central and Esan West; in contrast, major reductions were observed at Oredo and Igueben. Conclusion: The multi-faceted Federal and State Governments Intervention Policies and Strategies have apparently not been effective in the State. There is an urgent need for the intensification of efforts, including increase in the number of ITNs and upgrading of facilities at the Primary Health Care Centres for holistic diagnosis.